Bone fractures are debilitating injuries that affect millions of people around the world each year. Many of these fractures involve the long bones of the extremities including the femur, tibia, fibula, humerus, radius, and ulna. Fractures to these bones can be particularly painful, difficult to heal, and may require multiple surgeries with months of recovery.
When a patient enters the emergency room with a severe bone fracture, it is often accompanied by many other serious injuries. For instance, bone fractures are a frequent occurrence after a serious car accident, where often times the individual will also have head and respiratory trauma that is of primary concern. Though the critical injuries must be addressed first, once the patient is stable in the emergency department any serious fractures must be stabilized. The patient may need to be transported throughout the emergency department for various imaging and surgical procedures, so it is important to have the injured limb temporarily stabilized to reduce pain and prevent improper healing. Temporary stabilization may be required until the patient and his or her injuries are stable enough for a surgical procedure in the operating room to repair and permanently fixate the fracture. This temporary period can be anywhere from a few hours to a few weeks, depending on the injuries. Once placed, a permanent device may remain affixed for a number of weeks or even months, until the fracture is adequately healed.
There are several forms of temporary fracture stabilization methods including splinting, traction, and external fixation. Splinting may provide support along a fracture until the patient's other critical injuries are stabilized; however, such temporary devices are not always compatible with certain imaging techniques, such as magnetic resonance imaging (MRI), and don't actually fixate the fracture.
Traction is a method for temporary fracture stabilization used in many hospitals and emergency departments. Traction systems separate the two major bone fragments, properly aligning them (reduction) and facilitating proper healing. However, traction is a bulky procedure and can subject the patient to an uncomfortable position without the ability to move for an extended period of time. Bed transfers with this type of fixation are highly impractical, and very difficult to orchestrate.
External fixators have been used for over a century and have two widespread uses: temporary fixation and more permanent applications intended for a longer term treatment (permanent external fixation). Methods for permanent external fixation may utilize multi-pin circular frames and unilateral pin-bar systems. Though effective in stabilizing the fracture and keeping the fragments aligned for healing, the installation of these permanent fixation devices can take hours, and the complexity involved with unilateral and pin-point bone screw affixation can be complicated.
Temporary fixation involves the rapid temporary fixation of bone fractures using primarily unilateral pin-bar fixators to provide temporary stability while the patient is stabilized and care is provided during hospitalization. Current temporary fixators employ, at a minimum, four separate pins to achieve fixation. Such devices can take critical time to be applied and pose an increased risk for infection at the exposed sites of pin entry.